Abstract
Background: Previous research indicates that the physical environment of healthcare facilities plays an important role in the health, well-being, and recovery outcomes of patients. However, prior works on mental healthcare facilities have incorporated physical environment effects from general healthcare settings and patient groups, which cannot be readily transferred to mental healthcare settings or its patients. There appears to be a specific need for evidence synthesis of physical environmental effects in mental healthcare settings by psychopathology.Purpose: This review evaluates the state (in terms of extent, nature and quality) of the current empirical evidence of physical environmental on mental health, well-being, and recovery outcomes in mental healthcare inpatients by psychopathology.Method: A systematic review (PRISMA guidelines) was performed of studies published in English, German, Dutch, Swedish, and Spanish, of all available years until September 2020, searched in Cochrane, Ovid Index, PsycINFO, PubMed, and Web of Science and identified through extensive hand-picking. Inclusion criteria were: Adult patients being treated for mental ill-health (common mental health and mood disorders, Cochrane frame); inpatient mental health care facilities; specifications of the physical and socio-physical environment (e.g., design features, ambient conditions, privacy); all types of empirical study designs. Quality assessment and data synthesis were undertaken.Results: The search retrieved 1,068 titles of which 26 met the inclusion criteria. Findings suggest that there is only indicative evidence of the impact of the physical healthcare environment on patients' mental health, well-being, and recovery outcomes. There is significant lack of pathology-specific evidence. Methodological shortcomings and empirical scarcity account for the poor evidence.Conclusion: This review highlights the need for more research using advanced study designs.
Highlights
Treatment and recovery in mental health-care facilities has long been acknowledged to go beyond immediate therapeutic and pharmacological interventions
Robust, pathology-specific, experimental evidence excluded from this review suggests that visual and acoustic natural stimuli can reduce violent incidences in dementia patients [140]
These circumstances highlight the need to apply broader handpicking strategies, including expert consultation in future reviews. Another limitation of the current review is the strict inclusion/exclusion criteria, which resulted in the exclusion of a significant number of studies. Excluded studies were those that: focused on pathologies not listed in the Cochrane Framework of Common Mental Health Disorders; took place in forensic, rehabilitation, or ambulant/day-care settings; with mixed patient populations; merged psychosocial and environmental characteristics in their analysis; were expert interviews and non-peer-reviewed
Summary
Treatment and recovery in mental health-care facilities has long been acknowledged to go beyond immediate therapeutic and pharmacological interventions. Based on early evidence, such proponents argue that the course of treatment in mental health-care is largely affected by the organization and characteristics of the broader physical and social environment of the facility [5]. There appears to be a specific need for evidence synthesis of physical environmental effects in mental healthcare settings by psychopathology. Purpose: This review evaluates the state (in terms of extent, nature and quality) of the current empirical evidence of physical environmental on mental health, well-being, and recovery outcomes in mental healthcare inpatients by psychopathology
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